Pub Date : 2024-09-01Epub Date: 2024-05-15DOI: 10.1007/s11255-024-04067-9
B Mamatha, Sujatha P Terdal
In clinical decision-making for chronic disorders like chronic kidney disease, high variability often leads to uncertainty and negative outcomes. Deep learning techniques have been developed as useful tools for minimizing the chance and improving clinical decision-making. Moreover, traditional techniques for chronic kidney disease recognition frequently the accuracy is compromised as it relies on limited sets of biological attributes. Therefore, in the proposed work, a combination of deep radial bias network and the puma optimization algorithm is suggested for precised chronic kidney disease classification. Initially, the accessed data undergo preprocessing using Spectral Z score Bag Boost K-Means SMOTE transformation, which includes robust scaling, data cleaning, balancing, encoding, handling missing values, min-max scaling, and z-standardization. Feature selection is then conducted using the hybrid methodology of Role-oriented Binary Walrus Grey Wolf Algorithm to choose discriminative features for improving classification accuracy. Then, Auto Encoder with Patch-Based Principal Component Analysis is employed for dimensionality reduction to minimize the processing time. Finally, the proposed classification method utilizes deep radial bias and the puma optimization search algorithm for effective chronic kidney disease classification. The introduced scheme is tested on two datasets: the risk factor prediction of chronic kidney disease dataset and chronic kidney disease dataset, which provides accuracies of 99.02%, and 99.15%, respectively. Experiments demonstrate that the proposed model identifies chronic kidney disease more accurately than the existing approaches.
在慢性疾病(如慢性肾病)的临床决策中,高变异性往往会导致不确定性和负面结果。深度学习技术已被开发为有用的工具,可最大限度地减少偶然性并改善临床决策。此外,传统的慢性肾病识别技术往往依赖于有限的生物属性集,准确性大打折扣。因此,本文建议将深度径向偏置网络与 Puma 优化算法相结合,用于精确的慢性肾病分类。首先,利用光谱 Z score Bag Boost K-Means SMOTE 变换对访问的数据进行预处理,其中包括稳健缩放、数据清理、平衡、编码、处理缺失值、最小-最大缩放和 Z 标准化。然后,使用面向角色的二进制海象灰狼算法混合方法进行特征选择,以选择提高分类准确性的判别特征。然后,采用基于补丁的主成分分析的自动编码器进行降维,以尽量减少处理时间。最后,所提出的分类方法利用深度径向偏置和美洲豹优化搜索算法来有效地进行慢性肾病分类。引入的方案在两个数据集上进行了测试:慢性肾脏病风险因素预测数据集和慢性肾脏病数据集,准确率分别为 99.02% 和 99.15%。实验证明,与现有方法相比,所提出的模型能更准确地识别慢性肾病。
{"title":"An effective role-oriented binary Walrus Grey Wolf approach for feature selection in early-stage chronic kidney disease detection.","authors":"B Mamatha, Sujatha P Terdal","doi":"10.1007/s11255-024-04067-9","DOIUrl":"10.1007/s11255-024-04067-9","url":null,"abstract":"<p><p>In clinical decision-making for chronic disorders like chronic kidney disease, high variability often leads to uncertainty and negative outcomes. Deep learning techniques have been developed as useful tools for minimizing the chance and improving clinical decision-making. Moreover, traditional techniques for chronic kidney disease recognition frequently the accuracy is compromised as it relies on limited sets of biological attributes. Therefore, in the proposed work, a combination of deep radial bias network and the puma optimization algorithm is suggested for precised chronic kidney disease classification. Initially, the accessed data undergo preprocessing using Spectral Z score Bag Boost K-Means SMOTE transformation, which includes robust scaling, data cleaning, balancing, encoding, handling missing values, min-max scaling, and z-standardization. Feature selection is then conducted using the hybrid methodology of Role-oriented Binary Walrus Grey Wolf Algorithm to choose discriminative features for improving classification accuracy. Then, Auto Encoder with Patch-Based Principal Component Analysis is employed for dimensionality reduction to minimize the processing time. Finally, the proposed classification method utilizes deep radial bias and the puma optimization search algorithm for effective chronic kidney disease classification. The introduced scheme is tested on two datasets: the risk factor prediction of chronic kidney disease dataset and chronic kidney disease dataset, which provides accuracies of 99.02%, and 99.15%, respectively. Experiments demonstrate that the proposed model identifies chronic kidney disease more accurately than the existing approaches.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-02-24DOI: 10.1007/s11255-024-03977-y
Tuncay Sahutoglu
{"title":"Balancing superiority and applicability: considerations for urgent-start peritoneal dialysis.","authors":"Tuncay Sahutoglu","doi":"10.1007/s11255-024-03977-y","DOIUrl":"10.1007/s11255-024-03977-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-02DOI: 10.1007/s11255-024-04011-x
Xiaojing Zhuang, Bing Chen
{"title":"Commentary on ''Risk factors for infection and acute urinary retention following transperineal prostate biopsy''.","authors":"Xiaojing Zhuang, Bing Chen","doi":"10.1007/s11255-024-04011-x","DOIUrl":"10.1007/s11255-024-04011-x","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-27DOI: 10.1007/s11255-024-04033-5
Aymen Mabrouk, Laila Jedidi, Ahmed Saadi, Nada Essid, Senda Ben Lahouel, Yasser Karoui, Mounir Ben Moussa
{"title":"Sigmoid adenocarcinoma following ureterosigmoidostomy: a known complication of a no longer known procedure.","authors":"Aymen Mabrouk, Laila Jedidi, Ahmed Saadi, Nada Essid, Senda Ben Lahouel, Yasser Karoui, Mounir Ben Moussa","doi":"10.1007/s11255-024-04033-5","DOIUrl":"10.1007/s11255-024-04033-5","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-04-02DOI: 10.1007/s11255-024-04021-9
Hongbo Zeng, Ziyi Liu, Yunhui He, Huixiang Chen, Jun He, Mingke Liu, Shuiqing Wu, Haiqing He, Changkun Huang, Ran Xu
Background: This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi.
Methods: We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins.
Results: The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)].
Conclusions: Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.
研究背景本研究旨在探讨常见单种维生素和维生素组合摄入量的变化与肾结石发病率之间的关系:我们利用美国国家健康调查(NHANES)的数据,研究了九种常见维生素与肾结石患病率之间的关系。我们采用无监督 K-means 聚类方法将参与者分为几种维生素摄入模式。我们使用逻辑回归模型和限制性三次样条曲线来探讨维生素的影响:回归模型显示,与低摄入量相比,高摄入量的维生素 B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)]、维生素 C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)]和维生素 D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)]对肾结石的发病率具有保护作用。此外,限制性立方样条分析表明,随着维生素 B6 和维生素 D 摄入量的增加,对肾结石患病率的保护作用也会增强。此外,随着维生素 C 摄入量的增加,其保护作用可能会转化为风险因素。在混合暴露方面,与群组 1 相比,群组 4 对肾结石具有显著的保护作用[模型 3:OR(95% CI)= 0.79 (0.64, 0.98)]:我们的研究表明,维生素 B6 和维生素 D 摄入量高与肾结石发病率低有关。随着维生素 C 摄入量的逐渐增加,肾结石的发病率先下降后上升。此外,同时摄入九种维生素是肾结石的保护因素。
{"title":"Multivitamins co-intake can reduce the prevalence of kidney stones: a large-scale cross-sectional study.","authors":"Hongbo Zeng, Ziyi Liu, Yunhui He, Huixiang Chen, Jun He, Mingke Liu, Shuiqing Wu, Haiqing He, Changkun Huang, Ran Xu","doi":"10.1007/s11255-024-04021-9","DOIUrl":"10.1007/s11255-024-04021-9","url":null,"abstract":"<p><strong>Background: </strong>This research aimed to explore the association between changes in the intake of common individual vitamins and combinations of vitamins and the prevalence of kidney calculi.</p><p><strong>Methods: </strong>We used data from NHANES to investigate the association between nine common vitamins and kidney stone prevalence. Participants were clustered into several vitamin exposure patterns using an unsupervised K-means clustering method. We used logistic regression models and restrictive cubic spline curves to explore the influence of vitamins.</p><p><strong>Results: </strong>The regression model exposed that compared to lower intake, high intake of vitamin B6 [Q4: OR (95% CI) = 0.76 (0.62, 0.93)], vitamin C [Q4: OR (95% CI) = 0.73 (0.59, 0.90)] and vitamin D [Q4: OR (95% CI) = 0.77 (0.64, 0.94)] individually exerted protective effects against the prevalence of kidney stones. Furthermore, the restrictive cubic spline analysis showed that the protective effect against the prevalence of kidney stones is enhanced as the take of vitamin B6 and vitamin D increased. Moreover, with the increase in vitamin C intake, its protective effect may turn into a risk factor. Regarding mixed exposure, Cluster 4 exhibited a significant protective effect against kidney stones compared with Cluster 1 [Model 3: OR (95% CI) = 0.79 (0.64, 0.98)].</p><p><strong>Conclusions: </strong>Our research revealed that high levels of vitamin B6 and vitamin D intake were linked to a lower prevalence of kidney stone. With the gradual increase intake of vitamin C, the prevalence of kidney calculi decreased first and then increased. In addition, the co-exposure of nine vitamins is a protective factor for kidney stone disease.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-29DOI: 10.1007/s11255-024-04027-3
Yaiza María Yáñez-Castillo, Mercedes Nogueras-Ocaña, Antonio Jiménez-Pacheco, María Eugenia Folgueral-Corral, Miguel Arrabal-Martín
Purpose: This study aims to establish the ability of the Uroflex® external artificial sphincter to reduce the severity of male urinary incontinence and improve the quality of life of patients with male urinary incontinence.
Methods: A pre-post pilot study was carried out on a sample of 30 patients with male urinary incontinence. Tolerability and satisfaction were assessed by comparing the results of the Pad test, and EQ-5D and KHQ questionnaires before and after 3 months of using Uroflex®.
Results: At 3 months, 76.6% of patients continued using Uroflex®. The median score for overall satisfaction with the device was 8 out of 10. Pad test showed a significant reduction in the severity of male urinary incontinence at 3 months (p < 0.001), with resolution of all symptoms in 31% of patients. The KHQ showed a significant improvement in global quality of life (p = 0.003). This was also significant for five of the nine specific dimensions assessed. There was also an improvement in self-rated health using the EQ-5D questionnaire, although not significant (p = 0.075).
Conclusion: The Uroflex® external urinary sphincter seems to improve the severity of urinary incontinence and quality of life of patients with male urinary incontinence after prostate surgery. These encouraging results will need to be confirmed in larger controlled studies.
{"title":"Preliminary results of the external urinary sphincter Uroflex® on the quality of life of patients with male urinary incontinence after prostate surgery: tolerance, severity of incontinence, and quality of life.","authors":"Yaiza María Yáñez-Castillo, Mercedes Nogueras-Ocaña, Antonio Jiménez-Pacheco, María Eugenia Folgueral-Corral, Miguel Arrabal-Martín","doi":"10.1007/s11255-024-04027-3","DOIUrl":"10.1007/s11255-024-04027-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to establish the ability of the Uroflex® external artificial sphincter to reduce the severity of male urinary incontinence and improve the quality of life of patients with male urinary incontinence.</p><p><strong>Methods: </strong>A pre-post pilot study was carried out on a sample of 30 patients with male urinary incontinence. Tolerability and satisfaction were assessed by comparing the results of the Pad test, and EQ-5D and KHQ questionnaires before and after 3 months of using Uroflex®.</p><p><strong>Results: </strong>At 3 months, 76.6% of patients continued using Uroflex®. The median score for overall satisfaction with the device was 8 out of 10. Pad test showed a significant reduction in the severity of male urinary incontinence at 3 months (p < 0.001), with resolution of all symptoms in 31% of patients. The KHQ showed a significant improvement in global quality of life (p = 0.003). This was also significant for five of the nine specific dimensions assessed. There was also an improvement in self-rated health using the EQ-5D questionnaire, although not significant (p = 0.075).</p><p><strong>Conclusion: </strong>The Uroflex® external urinary sphincter seems to improve the severity of urinary incontinence and quality of life of patients with male urinary incontinence after prostate surgery. These encouraging results will need to be confirmed in larger controlled studies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-18DOI: 10.1007/s11255-024-04031-7
Chia-Ter Chao
{"title":"Considerations and alternative viewpoints on the efficacy of sodium bicarbonate as the lock solution for non-tunneled dialysis catheters.","authors":"Chia-Ter Chao","doi":"10.1007/s11255-024-04031-7","DOIUrl":"10.1007/s11255-024-04031-7","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-03-28DOI: 10.1007/s11255-024-04041-5
Lin Wang, Long Huang, Lei Lei, Yan Xu, Lijuan Huang, Hong Liu, Haiyan Wang, Dongliang Liu
Background: Small renal masses (SRMs) have been shown to have low malignant potential. Active surveillance (AS), typically characterized by regular follow-up and delayed nephrectomy if necessary, is recommended as an option for frail patients with SRMs. Nevertheless, the impact of tumor size on survival in T1a RCC patients undergoing delayed nephrectomy for SRMs remains unclear.
Methods: Patients diagnosed with non-metastatic T1a RCC who underwent nephrectomy were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into immediate (< 6 months) and delayed nephrectomy (≥ 6 months) groups based on the duration from diagnosis to nephrectomy. After propensity score matching (PSM), overall survival (OS) and cancer-specific survival (CSS) were estimated by K-M curves and compared with log-rank test.
Results: A total of 27,502 patients were enrolled, of whom 26,915 (97.9%) received immediate nephrectomy and 587 (2.1%) received delayed nephrectomy. After PSM, 1174 patients who underwent immediate nephrectomy and 587 patients who underwent delayed nephrectomy were included. With a median delay of 7 months, delayed nephrectomy resulted in non-inferior OS for RCC tumors sized 0.1-2.0 cm (HR = 1.12, p = 0.636). However, for RCC tumors sized 2.1-3.0 cm (HR = 1.60, p = 0.008) and 3.1-4.0 cm (HR = 1.89, p < 0.001), delayed nephrectomy showed inferior OS compared to immediate nephrectomy. Delayed nephrectomy did not result in significantly worse CSS than immediate nephrectomy in all tumor size subgroups (all p > 0.05), however this may be due to sample size limiting statistical power.
Conclusion: Based on the SEER database, we found that with a median delay of 7 months, 2 cm may be an appropriate cut-off point of delayed nephrectomy for patients diagnosed with non-metastatic T1a RCC.
{"title":"Effect of lesion dimension on survival in patients with T1a renal cell carcinoma who underwent deferred surgery.","authors":"Lin Wang, Long Huang, Lei Lei, Yan Xu, Lijuan Huang, Hong Liu, Haiyan Wang, Dongliang Liu","doi":"10.1007/s11255-024-04041-5","DOIUrl":"10.1007/s11255-024-04041-5","url":null,"abstract":"<p><strong>Background: </strong>Small renal masses (SRMs) have been shown to have low malignant potential. Active surveillance (AS), typically characterized by regular follow-up and delayed nephrectomy if necessary, is recommended as an option for frail patients with SRMs. Nevertheless, the impact of tumor size on survival in T1a RCC patients undergoing delayed nephrectomy for SRMs remains unclear.</p><p><strong>Methods: </strong>Patients diagnosed with non-metastatic T1a RCC who underwent nephrectomy were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into immediate (< 6 months) and delayed nephrectomy (≥ 6 months) groups based on the duration from diagnosis to nephrectomy. After propensity score matching (PSM), overall survival (OS) and cancer-specific survival (CSS) were estimated by K-M curves and compared with log-rank test.</p><p><strong>Results: </strong>A total of 27,502 patients were enrolled, of whom 26,915 (97.9%) received immediate nephrectomy and 587 (2.1%) received delayed nephrectomy. After PSM, 1174 patients who underwent immediate nephrectomy and 587 patients who underwent delayed nephrectomy were included. With a median delay of 7 months, delayed nephrectomy resulted in non-inferior OS for RCC tumors sized 0.1-2.0 cm (HR = 1.12, p = 0.636). However, for RCC tumors sized 2.1-3.0 cm (HR = 1.60, p = 0.008) and 3.1-4.0 cm (HR = 1.89, p < 0.001), delayed nephrectomy showed inferior OS compared to immediate nephrectomy. Delayed nephrectomy did not result in significantly worse CSS than immediate nephrectomy in all tumor size subgroups (all p > 0.05), however this may be due to sample size limiting statistical power.</p><p><strong>Conclusion: </strong>Based on the SEER database, we found that with a median delay of 7 months, 2 cm may be an appropriate cut-off point of delayed nephrectomy for patients diagnosed with non-metastatic T1a RCC.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-04-02DOI: 10.1007/s11255-024-04040-6
Naya Huang, Jianbo Li, Zhen Ai, Lin Guo, Wei Chen, Qinghua Liu
Purpose: To evaluate the differences in clinicopathological features and outcomes of IgA nephropathy (IgAN) patients with and without nephrotic syndrome.
Methods: In this retrospective cohort study, IgAN patients from January 2006 to December 2011 in the First Affiliated Hospital of Sun Yat-sen University were enrolled and followed up to Dec 31, 2013. Logistic and Cox regression were conducted to evaluate the associated factors of nephrotic syndrome (NS) and its relation with outcomes of creatinine doubling and progression to end-stage kidney disease (ESKD).
Results: A total of 1413 patients with IgAN were enrolled in this study, 57 (4.0%) of whom exhibited NS. Meanwhile, 13 (22.8%) of NS IgAN patients had minimal change disease (MCD). Logistic regression showed that more presence of hypertension, less glomerular sclerosis, less tubular atrophy/interstitial fibrosis, and lower density of IgA deposition in mesangial region were significantly associated with NS IgAN that were independent of age and gender. In addition, a total of 921 patients (890 with non-NS IgAN and 31 with NS IgAN) were followed up to Dec 31, 2013. After adjusting for age, sex, baseline estimated glomerular rate, hypertension and hemoglobin, no significant difference was observed in outcomes of serum creatinine doubling and ESKD between patients with or without NS IgAN.
Conclusions: Prevalence of NS IgAN patients was 4.0%, and 22.8% of them had MCD. Patients with NS IgAN had more severe clinical but less severe pathological features. However, outcomes of serum creatinine doubling and ESKD were not significantly different between patients with or without NS IgAN.
{"title":"Differences of clinicopathological characteristics and outcomes of IgA nephropathy patients with and without nephrotic syndrome.","authors":"Naya Huang, Jianbo Li, Zhen Ai, Lin Guo, Wei Chen, Qinghua Liu","doi":"10.1007/s11255-024-04040-6","DOIUrl":"10.1007/s11255-024-04040-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the differences in clinicopathological features and outcomes of IgA nephropathy (IgAN) patients with and without nephrotic syndrome.</p><p><strong>Methods: </strong>In this retrospective cohort study, IgAN patients from January 2006 to December 2011 in the First Affiliated Hospital of Sun Yat-sen University were enrolled and followed up to Dec 31, 2013. Logistic and Cox regression were conducted to evaluate the associated factors of nephrotic syndrome (NS) and its relation with outcomes of creatinine doubling and progression to end-stage kidney disease (ESKD).</p><p><strong>Results: </strong>A total of 1413 patients with IgAN were enrolled in this study, 57 (4.0%) of whom exhibited NS. Meanwhile, 13 (22.8%) of NS IgAN patients had minimal change disease (MCD). Logistic regression showed that more presence of hypertension, less glomerular sclerosis, less tubular atrophy/interstitial fibrosis, and lower density of IgA deposition in mesangial region were significantly associated with NS IgAN that were independent of age and gender. In addition, a total of 921 patients (890 with non-NS IgAN and 31 with NS IgAN) were followed up to Dec 31, 2013. After adjusting for age, sex, baseline estimated glomerular rate, hypertension and hemoglobin, no significant difference was observed in outcomes of serum creatinine doubling and ESKD between patients with or without NS IgAN.</p><p><strong>Conclusions: </strong>Prevalence of NS IgAN patients was 4.0%, and 22.8% of them had MCD. Patients with NS IgAN had more severe clinical but less severe pathological features. However, outcomes of serum creatinine doubling and ESKD were not significantly different between patients with or without NS IgAN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}